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General NPI Number Information
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NPI Number | 1205079209
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Entity Type | Individual
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Provider Name | GLENDA L. MATHEW NP
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Gender | Female
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Dates
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Enumeration Date | 04/07/2009
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 149 MAIN ST
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City | SOUTH RIVER
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State | NJ
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Zip | 08882-1232
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Country | US
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Telephone | 732-238-6440
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Fax | 732-651-1431
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Provider Business Mailing Address
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Address Line | 629 CRANBURY RD FL 2
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4096
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Country | US
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Telephone | 732-390-7750
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Fax | 732-390-7725
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ00175400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26N300175400
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License Number State | NJ
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